DisposeRx Packets:
Request for Purchase

Thank you for your interest in purchasing our DisposeRx at-home, abuse-deterrent. Solution. DisposeRx is committed to the eradication of unused medications.

Please complete the requested information below and a DisposeRx representative will contact to you within five business days. You may also call us at +1 (844) 456-1600.

* Please enter missing information in highlighted fields.

Contact Information

Organization Address

Organization Ship-To Address

Number of Packets Requested

Max words: 500
DisposeRx Packet Request

Please enter the number of packets you are requesting.

Submit

Thank You

Thank you for your interest in DisposeRx. We will follow up with you within five business days.

DisposeRx Packets:
Donation Application Form

DisposeRx is committed to the eradication of unused medications. As announced at the White House signing ceremony for the historic opioid legislation package known as HR-6, DisposeRx will be working with charitable organizations, faith—based groups and foundations to donate enough of our abuse—deterrent packets to destroy 10 million opioid tablets in home medicine cabinets across the nation.

If you represent a 501(c)3 organization, association, faith—based group or foundation and are interested in applying for a donation of DisposeRx packets, please complete and submit the following form. A DisposeRx representative will reach out to you within five business days.

Please include, based on the number of people you plan to reach, how many packets you are requesting, the project purpose and scope, and benefit to your community. Projects that will yield measurable program metrics and methods of quantifying success are preferred.

* Please enter missing information in highlighted fields.

Contact Information

Organization Address

Organization Ship-To Address

Number of Packets Requested

Max words: 500
BRIEF DESCRIPTION

In 500 words or less, please describe your organization and the program for which you are requesting donated DisposeRx Packets.

Submit

Thank You

Thank you for your interest in DisposeRx. We will follow up with you within five business days.

Contact
DisposeRx

* Please enter missing information in highlighted fields.

Contact Information

Organization Address

Organization Ship-To Address

Max words: 500
BRIEF DESCRIPTION

In general, what information would be most helpful to you?

Submit

Thank You

Thank you for your interest in DisposeRx. We will follow up with you within two business days.

Summary

To date, we have donated packets to 154 Community Partners in 44 states, including addiction support organizations, civic groups, churches, foundations, health departments, law enforcement agencies and many others. Our Community Partners never cease to amaze us with their commitment and creativity in developing education and promotion programs.

If you represent a 501(c)3 organization, association, faith—based group or foundation and are interested in applying for a donation of DisposeRx packets, please complete and submit our Community Outreach form. 

Please include the number of people you plan to reach, the number packets you may need, the project purpose and scope and benefit to your community. Projects that will yield measurable program metrics and methods of quantifying success are preferred.

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DisposeRx Inc.

503 Carthage Street, Suite 202

Sanford, NC 27330

+1 (844) 456-1600

Copyright 2017-2020 © DisposeRx Inc. All rights reserved.